Hip fractures in elderly with evaluation of risk factors

Background: Fractures in the neck and Perirtrochanteric region of hip contribute significantly to health problem globally. Primary occurrence in elderly osteoporotic people and create a major socioeconomical and public health problem. Almost every such fractures require surgery, hospitalization, and prolonged rehabilitation. The objective of the study was to evaluate the risk factors of hip fractures among the elderly population.Methods: This observational study was conducted among the elderly patients admitted in the department of orthopedics Government Medical College Jammu. Elderly patients regardless of sex and education admitted with hip fractures from August 2019 to July 2020 were included in the study.Results: There were 330 patients admitted with hip injuries. Among these 330 patients admitted with hip fractures, 205 (62.12%) were females and 125 (37.88%) males, mean age was 72.8 years. Age limit was >60 and <100 years. Majority of the patients i.e., 192 (58.18%) were in between the age group of 60 to 79 years.Conclusions: Increasing age is directly proportional to increasing incidence of hip fractures. This proportional rise can be reduced with early steps for prevention of osteoporosis and hence ultimately alleviate the disability and burden of the disease.

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Neurosarcoidosis Presenting With Recurrent Strokes

The Neurohospitalist ◽

10.1177/1941874416656730 ◽

2016 ◽

Vol 7 (2) ◽

pp. 91-95 ◽

Cited By ~ 2

Author(s):

Naheed Raza ◽

Karisa C. Schreck

Keyword(s):

Risk Factors ◽

Young People ◽

Elderly Patients ◽

Classification Scheme ◽

The Elderly ◽

Secondary Stroke Prevention ◽

High Grade ◽

Age Group ◽

Vascular Risk ◽

Recurrent Strokes

Neurosarcoidosis is a rare but important cause of stroke as it is treatable. Cases reported thus far have primarily been in young people who are relatively healthy. Here we report the case of a 73-year-old woman presenting with recurrent strokes and high-grade intracranial stenosis caused by probable neurosarcoidosis. This is unique as neurosarcoidosis is not usually considered as an etiology for recurrent strokes in our patient’s age-group. We review and categorize published cases of neurosarcoidosis causing stroke and describe a classification scheme for certainty of diagnosis. Given the implications of this diagnosis for secondary stroke prevention, we recommend that neurosarcoidosis be considered in the differential for patients with few vascular risk factors, recurrent strokes refractory to medical treatment, or possible vasculitis even in the elderly patients.

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Incidence and risk factors associated with postoperative stroke in the elderly patients undergoing hip fracture surgery

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-01962-6 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Lili Yu ◽

Yanbin Zhu ◽

Wei Chen ◽

Hui Bu ◽

Yingze Zhang

Keyword(s):

Risk Factors ◽

Hip Fracture ◽

Elderly Patients ◽

Hip Fractures ◽

Univariate Analysis ◽

Multivariate Logistic Regression Analysis ◽

The Elderly ◽

Individual Risk ◽

Factors Associated ◽

Postoperative Stroke

Abstract Objectives Stroke is one of the rare but devastating complications after hip fracture in the elderly. By far, there is still scarce data on postoperative stroke in elderly patients with hip fractures. Methods This was a retrospective study of prospectively collected data. Between October 2014 to December 2018, patients aged above 65 years who underwent operative treatment for hip fractures were included. Inpatient medical surveillance and scheduled telephone follow-up at 1, 3, 6, and 12 months after operation was conducted to identify who developed an incident stroke. Variables of interests were extracted from patients’ inpatient medical records. Univariate analysis and multivariate logistic regression analysis were used to identify the independent risk factors associated with stroke. Results During the study period, a total of 3743 patients were included, among whom 56 were found to have a stroke after operation, representing an incidence of 1.5% (95% CI, 1.1 to 1.9%). The multivariate analyses showed that advanced age (1-year increment; OR, 1.32; 95% CI, 1.08 to 1.48), history of previous stroke (OR, 4.79; 95% CI, 1.86 to 6.56), ASA III and above (OR, 2.62; 95% CI, 1.27 to 3.68), long-term use of aspirin (OR, 3.63; 95% CI, 1.41 to 4.78), and elevated RDW level (each increment of 1%, OR, 1.21; 95% CI, 1.02 to 1.36) were independently associated with postoperative stroke. Conclusions Although most are not modifiable, these risk factors help in counseling patients regarding the risk of postoperative stroke, individual risk stratification, and targeted optimization of medical conditions and should be firmly kept in treating surgeon’s mind.

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Visceral Leishmaniasis (Kala-azar) in Nepalgunj Medical College

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v16i2.24887 ◽

2018 ◽

Vol 16 (2) ◽

pp. 66-68

Author(s):

Shyam Kumar B.K. ◽

S. D. Bassi ◽

S. Baral ◽

A. Shah ◽

A. Dhakal

Keyword(s):

Public Health ◽

Visceral Leishmaniasis ◽

Health Problem ◽

Research Work ◽

Public Health Problem ◽

Sand Fly ◽

Age Group ◽

Major Health Problem ◽

Medical College ◽

Kala Azar

Background: Visceral leishmaniasis (VL) or Kala-azar is a potentially fatal vector-borne (sand fly phlebotomies spp) zoonotic disease caused by a protozoan parasite, Leishmaniadonovani. Kala-azar remains a public health problem in Nepal. The patient presented with a history of high-grade fever, abdominal distension, anemia, and weight loss. The disease is preventable, but various environmental, socioeconomic, health care and health behavior related variables affect its transmission. Objective: Find out the incidence of Kala-azar infection in Nepalgunj medical college. Method: This Hospital based study. Data was collected from April 2018to August 2018. Blood sample collected and test rk39 performed in laboratory of Nepalgunj Medical College Kohalpur. Result: Among 75 patients 16 were diagnosed kala-azar, rk39 positive 14 males and 2 females respectively. It is 12% of total cases. Among 16cases male are 14 and 2 are females. 85.7% male and 12.3% female. Age group between 15-30 years (31.25%), 31-45 years (25%), 46-60 years(18.75%), 61-75 years (12.5%), 76-85 years (12.5%). young people's age group 15-30 years are commonly infected. Conclusion: Visceral leishmaniasis (kala-azar) cases are still major health problem in Nepal. There should be regular surveillance research work to be carried out in both epidemic and non-epidemic districts of the country. Mass public health education, to make the people aware about preventive aspects of the disease is important.

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STUDY OF THYROID DYSFUNCTION IN ELDERLY PATIENTS MORE THAN 65 YEARS OF AGE GROUP

10.36106/paripex/1800704 ◽

2020 ◽

pp. 1-3

Author(s):

Jitendra singh ◽

Pankaj Han

Keyword(s):

Elderly Patients ◽

Clinical Features ◽

Thyroid Dysfunction ◽

Thyroid Function Test ◽

The Elderly ◽

Laboratory Evaluation ◽

Assay Method ◽

Age Group ◽

Chi Square ◽

Medical College

Aims and objectives: To study thyroid dysfunction and its clinical correlation in elderly patients more than 65 years of age group in Patna medical college & hospital, Patna. Material & methods: This study was conducted on 100 elderly patients in the department of medicine, Patna medical college & hospital, Patna.All patients of age more than 65 years with clinical suspicion of thyroid disorders were included in this study.All suspicious patients were examined clinically for detection of thyroid disorders.The laboratory evaluation of thyroid functions was done by estimation of serum T3,T4 and TSH levels by Chemiluminescence assay method. chi-square test was used for statistical data analysis. Results:In this study 100 elderly patients in the age group of more than 65 years were included.Out of which,30 patients were found to have abnormal thyroid function test, of which 23 patients had clinical features suggestive of hypothyroidism (13+10) and 7 patients had clinical features suggestive of hyperthyroidism (3+4).We have noted that as the age advances the incidence of thyroid dysfunction increases. Conclusion : Aim of this study was to know the various clinical aspect of presentation of thyroid dysfunction in the elderly population that differ from typical presentation.Incidence of thyroid dysfunction increases with increase in age

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Prevalence of Chronic Kidney Disease and Its Related Risk Factors in Elderly of Southern Iran: A Population-Based Study

ISRN Nephrology ◽

10.5402/2013/427230 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Leila Malekmakan ◽

Parviz Khajehdehi ◽

Maryam Pakfetrat ◽

Alireza Malekmakan ◽

Hamideh Mahdaviazad ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Health Problem ◽

Public Health Problem ◽

Fars Province ◽

Age Group ◽

Cross Sectional ◽

Southern Iran ◽

Related Risk

Aim. The prevalence of chronic kidney disease (CKD) as a serious public health problem is growing in the elderly. This study aimed to assess CKD prevalence and its related risk factors in elderly population of Fars province. Methods. In this cross sectional study a total of 1190 elderly people are enrolled, and demographic and medical data were obtained. Data were analyzed by SPSS, and P of less than 0.05 was considered as statistically significant. Results. Prevalence of CKD stages III–V was 27.5% in the 60–69 years age group, 36.5% in the 70–79 years age group, and 40% in the ≥80 years age group. The prevalence of CKD increased with ageing in both men and women. Female gender was the strongest risk factor for CKD. Conclusions. Prevalence of CKD in elderly is high in Southern Iran, which has become an important health problem while it can be prevented or delayed in progression.

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Hip fractures among the elderly in Kyoto, Japan: a 10-year study

Archives of Osteoporosis ◽

10.1007/s11657-021-00888-8 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Maki Asada ◽

Motoyuki Horii ◽

Kazuya Ikoma ◽

Tsuyoshi Goto ◽

Naoki Okubo ◽

...

Keyword(s):

Hip Fracture ◽

Femoral Neck ◽

Incidence Rate ◽

Acute Care ◽

Hip Fractures ◽

Age Groups ◽

The Elderly ◽

Femoral Neck Fractures ◽

Age Group ◽

Trochanteric Fractures

Abstract Summary In Kyoto Prefecture, Japan, the number of hip fractures increased during 2013–2017 compared to 2008–2012. However, the estimated overall incidence rate increased only in femoral neck fractures in men aged ≥75 and women aged ≥85. Purpose The incidence rate of hip fractures in Japan has plateaued or decreased. We investigated the annual hip fracture occurrences in Kyoto Prefecture, Japan, from 2008 to 2017. Methods Patients aged 65 years and above who sustained hip fractures between 2008 and 2017 and were treated at one of the participating 11 hospitals were included. The total number of beds in these institutions was 3701, accounting for 21.5% of the 17,242 acute-care beds in Kyoto Prefecture. The change in incidence rate was estimated utilizing the population according to the national census conducted in 2010 and 2015. Results The total number of hip fractures was 10,060, with 47.5% femoral neck fractures and 52.5% trochanteric fractures. A decrease in number was seen only in trochanteric fractures in the group of 75- to 84-year-old women. The population-adjusted numbers of femoral neck fractures showed a significant increase in all age groups in men, whereas in women, there was an increase in femoral neck fractures in the ≥85 group and trochanteric fractures in the age group 65–74, and a decrease in trochanteric fractures in the age group 75–84. The estimated change in incidence rate showed an increase in femoral neck fractures in men aged ≥75 and women aged ≥85. Conclusion In Kyoto Prefecture, the number of hip fractures increased in the second half of the study period (2013–2017) compared to the first half (2008–2012). However, the incidence rate had not increased, except in femoral neck fractures in men aged ≥75 and women aged ≥85.

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Prognosis and risk factors of ERCP pancreatitis in elderly

Scientific Reports ◽

10.1038/s41598-021-95484-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Erhan Ergin ◽

Nevin Oruç ◽

Galip Ersöz ◽

Oktay Tekeşin ◽

Ömer Özütemiz

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Elderly Patients ◽

Biochemical Analysis ◽

Female Gender ◽

The Elderly ◽

Imaging Findings ◽

Endoscopic Retrograde ◽

Sphincter Oddi ◽

Oddi Dysfunction

AbstractPost Endoscopic Retrograde Cholangiopancreatography (ERCP) pancreatitis is one of the most serious complications of ERCP. Our study aims to investigate the risk, predisposing factors and prognosis of pancreatitis after ERCP in elderly patients. Patients referred to the ERCP unit between April 2008 and 2012 and admitted to the hospital at least 1 day after the ERCP procedure were included to the study. Information including patient’s demographics, diagnosis, imaging findings, biochemical analysis, details of the ERCP procedure and complications were recorded. The severity of post ERCP pancreatitis (PEP) was determined by revised Atlanta Criteria as well as APACHE II and Ranson scores. A total of 2902 ERCP patients were evaluated and 988 were included to the study. Patients were divided into two groups as ≥ 65 years old (494 patients, 259 F, 235 M) and < 65 years old (494 patients, 274 F, 220 M). PEP was diagnosed in 4.3% of patients aged 65 years and older. The female gender was risk factors in elderly for PEP. The Sphincter Oddi Dysfunction (SOD) and Juxta papillary diverticula (JPD) were higher in elderly patients with PEP. Age did not increase the risk of PEP development. The most important post ERCP pancreatitis risk factor in the elderly is the female gender, while the risk is enhanced slightly by SOD and JPD.

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Risk factors for high length of hospital stay and in-hospital mortality in hip fractures in the elderly

Revista Española de Cirugía Ortopédica y Traumatología (English Edition) ◽

10.1016/j.recote.2021.05.009 ◽

2021 ◽

Vol 65 (5) ◽

pp. 322-330

Author(s):

J. Salvador Marín ◽

F.J. Ferrández Martínez ◽

C. Fuster Such ◽

J.M. Seguí Ripoll ◽

D. Orozco Beltrán ◽

...

Keyword(s):

Risk Factors ◽

Hospital Mortality ◽

Hospital Stay ◽

Hip Fractures ◽

Length Of Hospital Stay ◽

The Elderly ◽

High Length

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Abstract P614: Effect Sizes of Vascular Risk Factors for Stroke Occurrence by Age Among West Africans

Stroke ◽

10.1161/str.52.suppl_1.p614 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Mayowa Owolabi ◽

FRED S SARFO ◽

Onoja Akpa ◽

Joshua Akinyemi ◽

Albert Akpalu ◽

...

Keyword(s):

Risk Factors ◽

Middle Age ◽

Meat Consumption ◽

The Elderly ◽

Vascular Risk Factors ◽

Effect Sizes ◽

Modifiable Risk Factors ◽

Age Group ◽

Vascular Risk ◽

Elderly Age

Background: Age is a non-modifiable risk factor for stroke occurrence due its influence on vascular risk factor acquisition. In sub-Saharan Africa, the effect sizes of vascular risk factors for stroke occurrence by age is unknown. Objective: To quantify the magnitude and direction of the effect sizes of key modifiable risk factors of stroke according to three age groups: <50years(young), 50-65 years(middle age) and >65 years(elderly) in West Africa. Methods: The Stroke Investigative Research and Educational Network (SIREN) is a multicenter, case-control study involving 15 sites in Ghana and Nigeria. Cases include adults aged ≥18 years with evidence of an acute stroke. Controls were age-and-gender matched stroke-free adults. Detailed evaluations for vascular, lifestyle, stroke severity and outcomes were performed. We used conditional logistic regression to estimate adjusted odds ratios (aOR) of vascular risk factors of stroke. Results: Among 3,553 stroke cases, 813(22.9%) were young, 1441(40.6%) were middle-aged and 1299(36.6%) were elderly. Five modifiable risk factors were consistently associated with stroke occurrence regardless of age namely hypertension, dyslipidemia, diabetes mellitus, regular meat consumption and non-consumption of green vegetables. Among the 5 co-shared risk factors, the effect size, aOR(95%CI) of dyslipidemia, 4.13(2.64-6.46), was highest among the young age group, hypertension, 28.93(15.10-55.44) and non-consumption of vegetables 2.34(1.70-3.23) was highest among the middle-age group while diabetes, aOR of 3.50(2.48-4.95) and meat consumption, 2.40(1.76-3.26) were highest among the elderly age group. Additionally, among the young age group cigarette smoking and cardiac disease were associated with stroke. Furthermore, physical inactivity and salt intake were associated with stroke in the middle-age group while cardiac disease was associated with stroke in the elderly age group. Conclusions: Age has a profound influence on the profile, magnitude and direction of effect sizes of vascular risk factors for stroke occurrence among West Africans. Population-level prevention of stroke must target both co-shared dominant risk factors as well as factors that are unique to specific age bands in Africa.

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Two Types of Anesthesia and Hemodynamic Changes in Patients Over 60 Years of Age Who Need Artificial Femoral Head Replacement: A Retrospective Cohort Study

10.21203/rs.3.rs-389572/v1 ◽

2021 ◽

Author(s):

Weiqi Ke ◽

Yuting WANG ◽

Xukeng GUO ◽

Ronghua HUANG ◽

Xiangdong ZHANG ◽

...

Keyword(s):

Blood Pressure ◽

Femoral Head ◽

Elderly Patients ◽

The Elderly ◽

Hemodynamic Changes ◽

Medical College ◽

Replacement Surgery ◽

Elder Patients ◽

Significant Difference ◽

And Gender

Abstract Background:Artificial femoral head replacement is one of the most effective methods for treatment of severe diseases of femoral joint in the elderly. The ideal anesthetic effect is one of the key elements for the success of the operation because it brings fast recovery. However, the multiple comorbidities of the elder patients make them too weak to tolerate the hemodynamic changes after anesthesia. In this case, the most suitable anesthesia method for patients undergoing femoral head replacement surgery is of great significance.Objective:To compare the post-anesthetic hemodynamic changes between combined lumbar plexus and sciatic nerve block(CLPSB) and combined spinal and epidural anesthesia(CSEA) in elderly patients undergoing unilateral artificial femoral head replacement.Methods:We reviewed records of the patients who aged over 60 years old (age 62-103 years) and received unilateral artificial femoral head replacement between January 2015 and December 2020 in the first affiliated hospital of Shantou University Medical College. After adjustment according to the inclusion criteria, 477 patients were included and divided into CLPSB group (n=90) and CSEA group (n=387). The primary outcome was comparison of the hemodynamic changes after anesthesia, including the systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR). The second outcome was the comparison of the vasopressor used during the surgery.Results:We established three models to compare the two anesthesia methods on hemodynamic changes. Crude model included all variates for analysis, while model I adjusted age and gender. Model II adjusted other comorbidities in addition to model I. All three models exhibit that changes of MAP (∆MAP) after CSEA were higher than that after CLPSB(β= 6.88, 95% CI: 4.33 - 9.42, P < 0.0001), with significant difference, which indicated that CSEA causes higher fluctuation of MAP. Concurrently, the use of vasopressors increased by 137% (OR=2.37, 95%CI: 1.24-4.53, P=0.0091) in the CSEA group, which is statistically significant. However, the changes of HR (∆HR) between the CLPSB and CSEA was not significant(β= 0.50, 95% CI: 1.62 - 2.62, P = 0.6427). Conclusions:Both CLPSB and CSEA are ideal anesthesia methods for patients receiving femoral head eplacement, though CLPSB is more suitable for elderly patients with advanced hemodynamic stability.

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